Chapter Seven: Reflections on reflective practice
This is a Reflective Practice Exercise that acknowledges the costs and benefits of being a reflective practitioner.
Objective: to learn as a team from actual case studies by discussing and sharing relevant personal experience.
Format:
A. Presenter shares some guidance on ‘Reflective Practice’
B. The Reflective Group are split into groups of four
C. The groups of four read and discuss the case study
D. Allow for a short plenary to end the session
Timing: Allow 45 minutes
Reflections on reflective practice
Are there any difficulties in becoming a reflective practitioner?
Yes! The most common seems to be time. We all have busy lives, so being realistic about what you can reflect on is important.
If you are able to factor it into your everyday work activities, great. If not, be selective.
Procedure for reflective practice.
1. Recall it: this could be a visit or an encounter you have had or an enquiry you’ve responded to.
2. Evaluate it: You need only select one or two of the bullet points here or add one of your own:
• What is really happening regarding these patients?
• What was interesting or worrying?
• What can you conclude generally about the situation this patient is in?
• What did the patient or their family say and think about their illness? (if appropriate)
• What were the patient’s concerns and expectations?
• What did the staff say and think? (if appropriate)
• What has been done well with regard patient’s care?
• What could be done differently?
• What did you learn about yourself?
• Can you identify future learning needs?
3. Apply it: Agree to take some action to practically apply your learning from the experience you have had.
Reflective practice, helps you be more objective about experiences and is a practical way of learning and development
Split into groups of four for this reflective exercise:
Reflective Exercise using a case study of a visit to a general surgical ward in the local hospital
A Chaplaincy Visitor on her routine visits to a Ward entered a 4-bed bay. There were three patients in the bay. One patient was not present. The Chaplaincy Visitor introduced herself to the patients in the bay. Two patients in their 50s were awake and sitting up on their beds. Both smiled and returned the greeting. The Chaplaincy Visitor moved to the bedside of the first patient and spent some time listening to the patient’s concerns about her situation and lack of progress in terms of diagnosis and treatment. After some words of encouragement, the Chaplaincy Visitor left the bedside.
As she did so she noticed that the patient diagonally opposite had now closed her eyes and appeared to be resting. Her arms were folded in front of her and her legs were crossed.
The Chaplaincy Visitor then walked towards the third patient; a frail elderly lady whom the volunteer had observed on entering the ward appeared to be sleeping in her chair. She had her head in her hands and was leaning forward in her chair. The visitor went over, knelt down by her chair and gently said ‘Hello.’
The lady raised her head, she looked sad and downhearted. The volunteer introduced herself and enquired how things were with her today. She responded by saying she was fed up and would be glad to get out of the place. From the conversation, it was clear that this patient had been upset by the attitude of some staff towards her. “They don’t listen to me”, she said, “They are trying to make me walk. I can’t walk without someone supporting me, I’ve just had a hip replacement. I can’t do it anymore.”
Where would you take this conversation?
On leaving the bay, the visitor noticed that the fourth patient had returned, she was also an elderly lady. The volunteer went over to her and she immediately recognized her from a previous stay in hospital. She smiled, shook the volunteer’s hand and said how glad she was to see her. Conversation flowed freely as she told the Chaplaincy visitor why she was in hospital and how fed up she was that no one was telling her what was happening. She had been waiting 6 days for a scan. She was trying to help herself by sitting more upright so that she can breathe more easily. “There is nothing wrong with my mind” she said, “I want to know what they are thinking, I want to know everything. I don’t like not being told anything.”
Where would you take this conversation?
Towards the end of the conversation, the visitor remembered that this patient may have received the sacrament of Holy Communion on her last time in the hospital. She offered it again and the patient responded positively saying she would appreciate it as she is in need of a bit of help.
What communication skills was the Chaplain using in this ward visit?
Bob Warton in ‘Reflective Caring’ suggests that chaplaincy visitors are burden sharers and should not suppress it. ‘If we jump in a river we will wet,’ that is the risk of loving (Warton). We are bound to be affected by the caring work we do. Reflective Practice gives balance and support and aids learning and growth through our practice.
